The ambitious goal of research combining diabetes and genetics is to discover the cause of, and targeted care for, type 2 diabetes.

One prerequisite for better care of diabetes is a clearer understanding of the associated spectrum of diseases.

A research project started early this year aims to identify the role of heredity in type 2 diabetes. Funded by the Academy of Finland, this five-year project is led by FiDiPro Professor Leif Groop, Head of the Lund University Diabetes Centre in Sweden and one of the world’s best known diabetes researchers.

State-of-the-art genetic methods and the special features of the Finnish population are being used to discover the mechanisms behind type 2 diabetes. The FiDiPro project partly dovetails with the international SISu project (Sequencing Initiative Suomi), which involves the detailed gene mapping of the Finnish population.

Long-term collaboration between the Lund University Diabetes Centre and the Institute for Molecular Medicine Finland (FIMM) lies behind the FiDiPro project. Professor Aarno Palotie of FIMM acts as a second project leader. International cooperation in the area is very close and active. In addition to the universities of Helsinki and Lund, the US Broad Institute, which specialises in genetics, is also part of the research network. With so much knowledge to explore, the work needs to be divided out.

“It’s extremely advantageous to combine genetics and diabetes research resources. No one can single-handedly process and handle such masses of information,” explains Groop, who likens the partners to a small family.

Diabetes has been the focus of Groop’s life work. He became interested in the disease when in his first post, at Närpes, Finland, in the late 70s. After specialising at the University of Helsinki, Groop moved to Lund, where he has spent almost 20 years.

Genome map will open up new avenues

The field of genetics has seen huge developments over the last few decades. Wholesale understanding of hereditary factors will help uncover the mechanisms behind type 2 diabetes.

“Finland, with its history of rapid population growth and small gene pool, is a geneticist’s paradise,” Groop suggests.

Groop is also involved in the Botnia Study, begun in 1990, which is investigating the prevalence of diabetes in the population of Ostrobothnia, Finland. This has led to the collection of a significant amount of data on the hereditary background of Finns. Groop and his research team will make use of this information in the FiDiPro project.

Diabetes is the sum of many factors

Type 2 diabetes is now the fastest growing disease. Some 250,000 Finns are affected by it, plus an estimated 200,000 undiagnosed cases. Both hereditary factors and changing living conditions are leading to the disease’s greater prevalence.

“People now burn 500 fewer calories per day than a few decades ago, and this is the key cause of being overweight. Changes in our metabolism are far slower than those in our environment,” Groop sums up.

At the moment, there is no effective treatment for type 2 diabetes, which is a progressive disease. Complications of diabetes, such as eye and kidney diseases, circulation problems and nerve damage, as well as cardiovascular conditions, reduce the patient’s quality of life. Type 2 diabetes is also a major economic burden on society.

Buy a dog and get off the sofa!

Many means already exist of avoiding type 2 diabetes. Even for people genetically predisposed to the disease, lifestyle can be important to its prevention.

“Exercise is always good for you. It’s also worth remembering that prevention is much easier and cheaper than medical care,” Groop points out.

Groop praises the expertise of Finnish doctors. Finland also has an active Diabetes Association.
“However, it’s worth remembering that almost half of all diabetes cases are undiagnosed. Routine measurement of patients’ blood glucose levels is important to diagnosing the disease in its early stages.”

Targeted treatment equals better treatment

In the future, diabetics will be diagnosed more precisely than now.

“Diabetes is associated with a very broad range of diseases. Despite the frequent, simplifying division of the disease into two types, there’s no such thing as a single diabetes type 1 or 2. Instead, the disease takes a vast spectrum of forms,” Groop explains.

A precise diagnosis means better targeted directions for the disease’s treatment. In the future, patients will be provided with much more plentiful, far more detailed information on the disease and its prognosis. Doctors will be able to explain the most appropriate types of care, and the associated risks and side-effects.

“I will be very disappointed if, in ten years’ time, a medicine hasn’t been invented that helps the pancreas to secrete insulin. Such a medicine would not only slow the progress of the disease, but prevent its occurrence,” Groop affirms.

“Improving people’s quality of life is the first priority. Naturally, given the excellent basis and resources of our research, ambitious goals have been set. And we have got to achieve them,” Groop adds.

Original text in Finnish, photo: Heidi Taustila